Seen but Not Heard: Dissent-Proof Design and the Quiet Override in Dementia Surveillance.

The article critically examines the ethical implications of wearable tracking devices used in dementia care, focusing on a case where a resident, Mr. Jenkins, is fitted with a location-tracking bracelet relocated from wrist to ankle to reduce his distress. This relocation conceals the device from hi...

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Publicado en:American Journal of Bioethics Vol. 26; no. 9; pp. 167 - 171
Autor principal: Yang, Y. Tony
Formato: commentary Journal Article
Publicado: Taylor & Francis Ltd Sep2026
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Taylor & Francis Ltd
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        atl: Seen but Not Heard: Dissent-Proof Design and the Quiet Override in Dementia Surveillance.
      aug:
        au: Yang, Y. Tony
        affil: The George Washington University
      sug:
        subj:
          Dementia Therapy
          Patient Safety
          Relational Autonomy
          Privacy and Confidentiality
          Ethics, Medical
          Geographic Information Systems
          Residential Care
          Disease Surveillance
          Politics
          Bioethics
          Patient Rights
          Equipment Design Ethical Issues
          Residential Facilities
          Nonverbal Communication
      ab: The article critically examines the ethical implications of wearable tracking devices used in dementia care, focusing on a case where a resident, Mr. Jenkins, is fitted with a location-tracking bracelet relocated from wrist to ankle to reduce his distress. This relocation conceals the device from his awareness, effectively silencing his nonverbal refusal and transforming his autonomy into compliance through what the author terms "dissent-proofing"—design strategies that minimize opportunities for residents to express refusal. The article advocates for a "dissent-by-design" approach that preserves and respects the capacity to refuse by making removal a protected, communicative act, ensuring responsive channels for resident-initiated signals, and maintaining perceptibility of devices to uphold spatial liberty. It also highlights the need for ethical safeguards, including strict data-use limitations and adequate staffing to respond to dissent, emphasizing that true ethical surveillance must allow residents not only to be seen but also to refuse and be heard.
      pubtype: Academic Journal
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        commentary
        Journal Article
      ougenre: Article
    language: English
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